National Provider Identifier [NPI]: |
1538151642 |
Last Name Of The Provider |
CACERES |
First Name Of The Provider |
MAURICIO |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
100 ARROW SPRINGS BLVD |
Street Address 2 Of The Provider |
SUITE 2800 |
City Of The Provider |
LEBANON |
Zip Code Of The Provider |
450369864 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
36 |
Number Of Services |
835 |
Number Of Medicare Beneficiaries |
179 |
Total Submitted Charge Amount |
89389 |
Total Medicare Allowed Amount |
64530.35 |
Total Medicare Payment Amount |
43312.97 |
Total Medicare Standardized Payment Amount |
45606.73 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
9 |
Number Of Drug Services |
117 |
Number Of Medicare Beneficiaries With Drug Services |
67 |
Total Drug Submitted ChargeAmount |
3845 |
Total Drug Medicare AllowedAmount |
1964.75 |
Total Drug Medicare PaymentAmount |
1911.48 |
Total Drug Medicare Standardized Payment Amount |
1911.48 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
27 |
Number Of Medical Services |
718 |
Number Of Medicare Beneficiaries With Medical Services |
179 |
Total Medical Submitted Charge Amount |
85544 |
Total Medical Medicare Allowed Amount |
62565.6 |
Total Medical Medicare Payment Amount |
41401.49 |
Total Medical Medicare Standardized Payment Amount |
43695.25 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
24 |
Number Of Beneficiaries Age 65 to 74 |
82 |
Number Of Beneficiaries Age 75 to 84 |
50 |
Number Of Beneficiaries Age Greater 84 |
23 |
Number Of Female Beneficiaries |
100 |
Number Of Male Beneficiaries |
79 |
Number Of Non Hispanic White Beneficiaries |
156 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
147 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
32 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
13 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
16 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
62 |
Percent Of With Ischemic Heart Disease |
26 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0891 |